Preclinical Alzheimer Cognitive Composite (PACC) decline was associated with faster longitudinal atrophy across a wide set of cortical regions, as well as the hippocampus and thalamus (allocortical and subcortical regions not depicted). Regions were averaged across the left and right hemispheres. Models were adjusted for age, sex, education, APOE ε4 status, and their interactions with time. Color bars indicate the t statistic for the association between PACC decline and brain atrophy. Regions are shown at p < 0.05 after FDR correction for multiple comparisons.